Seeing your doctor

Each of the three major prostatic diseases eloquently illustrates the ‘stitch in time’ principle. A ‘window of curability’ exists for prostate cancer, but once this is closed, neither surgery nor radiotherapy is likely, ultimately, to be successful. With BPH, several studies have confirmed that there is a level of secondary damage to the bladder caused by obstruction after which complete recovery becomes less likely. And if prostatitis becomes chronic, then repeated and prolonged courses of treatment are often needed.

When should you go?

Regular prostate checks allow prostate disease to be detected at a stage when it can generally be resolved, while preventive strategies may reduce the risks of disease developing in the first place. It makes good sense to combine these with regular, more general health checks to diagnose other potentially dangerous conditions such as high blood pressure, raised cholesterol and diabetes. In a way, then, the prostate provides the key to more general men’s health.

It is generally advisable for men over 50 to have an annual health check, which should include an assessment of the prostate, including a PSA test. While a one-off PSA check provides a certain amount of information, regular checks are more informative because they show the rate of the rise in PSA (sometimes called the ‘PSA kinetics’). A sudden rise in PSA is rather like a flashing light on the dashboard of your car; it tells you that something is amiss, which, if responded to appropriately, will help to prevent eventual breakdown. You may have to ask for a PSA test as not all doctors will offer it routinely. Write down and keep the result as it’s always a good thing to ‘know your numbers’.

Specific symptoms to prompt a visit. Problems with urinating are the most common symptoms of prostate disease. You should visit your doctor if you regularly experience one of the following:

A weak, sometimes intermittent flow of urine

Difficulty starting to urinate

A need to urinate frequently

A need to urinate urgently (you do not feel able to put it off)

Having to go to the toilet several times during the night

A feeling that your bladder is not completely empty after you have finished urinating

Pain or burning when passing urine

Blood in your urine (this is particularly important).

See your doctor regularly and promptly

If men wait for symptoms, they may wait too long

Men with prostate disease can be cured by a little knowledge and timely action

A ‘window of curability’ exists for prostate cancer

If cancer is to be identified at a stage when it is still curable, then it should be detected before the PSA rises much above 10 ng/mL (see next chapter)